Objective: To investigate the effect of moderate alcohol consumption on fat distribution, adipose tissue secreted proteins (adiponectin and resistin), and insulin sensitivity in healthy middle-aged men with abdominal obesity. Research Methods and Procedures: Thirty-four healthy men between 35 and 70 years old, with increased waist circumference (≥94 cm), participated in a randomized, controlled cross-over design trial. They drank 450 mL of red wine (40 grams of alcohol) or 450 mL of de-alcoholized red wine daily during 4 weeks. At the end of each treatment period, fat distribution, adipose tissue proteins, and insulin sensitivity index (ISI) were measured. Results: Subcutaneous and abdominal fat contents and body weight did not change after 4 weeks of moderate alcohol consumption. Liver fat (quip index) was slightly higher after consumption of red wine (6.8 ±0.1) as compared with de-alcoholized red wine (6.5 ±0.1) but not significantly different (p = 0.09). Plasma adiponectin concentration increased (p < 0.01) to 6.0 ± 0.1 μg/mL after 28 days of moderate alcohol consumption compared with de-alcoholized red wine (5.5 ±0.1 μg/mL). Serum resistin concentrations and ISI were not affected by alcohol consumption. Percentage changes in serum resistin correlated signifi cantly with changes in ISI (r = -0.69, p < 0.01), whereas this correlation was not present between changes in plasma adiponectin and ISI (r = 0.31, p = 0.22). Discussion: Moderate alcohol consumption for 4 weeks is not associated with differences in subcutaneous and abdominal fat contents or body weight. Thus, the 10% increase in adiponectin was not associated with a change in fat distribution or body weight change. Copyright © 2006 NAASO.